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Medicare Rebates for ADHD Assessment: What's Covered

Medicare covers part of an ADHD assessment through a handful of specific item numbers, not the whole cost. Here is what items 82000, 291, 296 and 23 actually pay for, and what is left for you to cover.

Medicare rebates ADHD assessment costs through four main item numbers: 82000 for a psychologist, 291 and 296 for a psychiatrist, and 23 for the GP consultation that gets the referral moving. None of them cover the full cost of an assessment. Not close. Nationally, total assessment costs average close to $1,400, according to 2026 University of Wollongong reporting, and the initial adult session alone averages more than $530 before any rebate is applied.

Item 82000: the psychologist rebate, and its limits

Item 82000 rebates 85 percent of a $119.45 fee ($101.55) for a psychologist session of at least 50 minutes that contributes to diagnosing a complex neurodevelopmental condition like ADHD, but only for a patient under 25. It also carries a lifetime cap of 8 services across a related group of item numbers, with a review required after the first 4. Once someone turns 25, or the cap is used up, this specific rebate no longer applies and psychologist-led assessment sessions are generally billed privately.

Items 291 and 296: the psychiatrist rebates

A psychiatrist attendance longer than 45 minutes is rebated 85 percent of a $549.90 fee ($467.45) under item 291, provided the GP referral is for assessment and development of a 12-month mental health management plan, and provided the psychiatrist sends a written report back to the referring GP within two weeks. Item 296 covers a first attendance with a new psychiatrist, or one not seen in the past 24 months, without that management-plan framing, rebated 85 percent of a $316.30 fee ($268.90). Neither item is age-restricted the way item 82000 is.

Item 23: the GP consultation that starts it all

Item 23 is the standard GP consultation, 6 to 20 minutes, rebated at 100 percent of a $45.05 fee. It is the smallest item on this list in dollar terms, but it is the one almost every pathway passes through first, since a referral from a GP is what qualifies you for the higher psychiatrist rebate and, in most cases, is expected before a psychologist or psychiatrist will book an assessment at all.

What's left for you to cover

Add the rebates up and Medicare still leaves most of the bill with the patient. Assessment usually takes more than one session, item 291 covers less than the full $549.90 fee, and item 82000 only applies under 25. That is the gap behind the national figure of close to $1,400 in average total assessment costs, some running close to $4,000, from the same 2026 University of Wollongong reporting.

What happens after diagnosis, cost-wise

If medication becomes part of the plan once ADHD is diagnosed, the PBS, not the MBS items above, sets the next cost. From 1 January 2026, a general patient pays up to $25.00 per PBS medicine, reduced from $31.60, and a concession card holder pays $7.70, a rate frozen until 2029. If PBS medicine costs add up over a year, the safety net threshold sits at $1,748.20 for general patients and $277.20 for concession card holders, after which the government covers more of the cost for the rest of that year.

Common questions

Sources

• Medicare Benefits Schedule: item 291
• Medicare Benefits Schedule: item 296
• Medicare Benefits Schedule: item 82000
• Medicare Benefits Schedule: item 23
• University of Wollongong: A 12-month wait and a $1,400 bill
• PBS: current patient fees and charges

Related reading

• Getting a GP referral for an ADHD assessment
• ADHD assessment cost and wait time in Australia
• The psychologist pathway to ADHD assessment